???? Understanding CPT Code 91035 for GERD Diagnosis

Introduction:

GERD diagnosis requires precise acid monitoring between stomach and esophagus.
In medical billing, CPT Code 91035 is billed for the gastroesophageal reflux test. Proper documentation during claim submission is essential for correct reimbursements. Therefore, clinics often delegate billing tasks to streamline cash flow.

???? What is CPT Code 91035?

The American Medical Association (AMA) establishes guidelines for billing accuracy. CPT 91035 reports a gastroesophageal reflux test, commonly referred to as the Bravo Capsule code. This procedure uses Bravo Capsule placement to record esophageal acid exposure. Proper documentation supports payer understanding.

???? Applicable Modifiers for CPT 91035

Several modifiers can accompany CPT 91035 under specific clinical circumstances. Let’s break down them:

• Modifier 26: Indicates the physician’s portion of service.


• Modifier TC: Reports the procedural performance aspect.


• Modifier 52: Applied when part of the procedure is omitted


• Modifier 53: Used if the procedure is discontinued


• Modifier 59: Reports separate, non-overlapping procedures.


• Modifier 76: Shows repeat procedure by same provider


• Modifier 77: Indicates separate provider involvement.

⚖️ Relation Between CPT 91035 and 00812?

No, here they are not related.
CPT 91035 is used for reflux diagnosis, while website CPT 00812 refers to anesthesia during colonoscopy

???? Top CPT 91035 Coding Mistakes

1️⃣ Incorrect Modifier Usage

When coders choose the wrong modifier for CPT 91035, claims may be denied. Always double-check the CPT pairing before submission.

2️⃣ Missing Details in Billing

Incomplete or incorrect details can cause reimbursement delays. Ensure completeness in every billing field, including all claim data.

???? Conclusion

Gastroesophageal reflux disease diagnosis involves analyzing acid backflow with pH monitoring.
Providers bill under CPT Code 91035 to receive appropriate reimbursement. Correct modifier usage and precise billing enhance financial performance.